A Quick Dip

studenthealth travel, Uncategorized , , , , , ,

“Jump in”…

“Come on In” I hear them shout… The water looks cool and inviting, the surface twinkling under the sun. I’m hot and sweaty and in desperate need to feel cold water on my skin. I hear them all splashing in the water, laughing calling me in to join them… Beads of sweat have formed on my forehead, I wipe them away- my T-shirt has stuck to my back where I was carrying my daypack.

I do so want to run in, or at least take my sandals off and feel the coolness on my hot feet-  but something in my head tells me no… Why? I retrace my thoughts and vaguely remember something the nurse said in the travel clinic something about snails and freshwater…? and that Lake Malawi was high risk… ?

I can’t see anything in the water- I’m getting hotter and everyone is now in the water- calling me in to join them… What harm can it do?

 I take off my sandals and join in the fun- such a relief from the heat of the sun….

 I think nothing more of it… and 4 months later I am back in Bristol uploading my travel photos onto facebook. I find a selection of leaflets amongst my travel documents that I must have collected from the nurse in the travel clinic- one of them mentions something called ‘Schistosomiasis’ (Bilharzia).

Ahhhh this is the disease that I recalled at Lake Malawi- but I feel totally ok, not unwell at all- so I don’t think I have to worry about this. I start reading the information and it states:

‘The majority of people who contract Schistosomiasis have no symptoms’!

Oh!

But fortunately I can have a screening test 12 weeks after possible exposure which I can have done at my GP practice.

I ring up Students’ Health Service and book a nurse appointment.

Better to check after my quick dip…

 

Schistosomiasis is one of the most widespread of all parasitic infections of humans. It is the most common parasite transmitted through contact, by either swimming or wading in fresh water in parts of Africa, for example Lake Malawi. South America and the Middle and Far East are also affected.

Initial contact with cercariae can cause an itchy rash, known as “swimmers itch.” Once infection has been established, clinical manifestations/ symptoms can occur within 2-3 weeks of exposure, but many infections cause no symptoms.

 

Advice for Travellers

Avoid skin contact with fresh water in endemic areas e.g. ponds, lakes and rivers. Swim only in protected swimming pools or safe sea water. Avoid drinking infected water. Wear protective footwear when walking in soil, especially if it is damp or water logged. Those who have been knowingly exposed can be screened after return but if there are no symptoms this should be delayed for 12 weeks after the last possible exposure so as to allow the time for the development of antibodies.

 

Sources:

Students’ Health Service ‘Travel Guidelines’ patient information leaflet- available at the practice

http://www.nathnac.org/travel/factsheets/schistosomiasis.htm.

 

Taking Risks

studenthealth travel, Uncategorized , , , , ,

“I’m lying here with a drip in my arm on a hospital bed, gazing out of the window, watching a couple of local children playing with a tin can, wishing I was out there in the sun… Thank goodness I had taken out good travel insurance as I was advised; otherwise this ‘cheap’ backpacking trip would have cost me and my family a fortune in hospital costs…

Being admitted to hospital in India was not on our travel plans.

I feel so sorry for my friends who have cut their holiday short to stay and look after me and update my worried parents on my progress…

 How did I end up here you may ask? Well now, that’s a good question…

Between the many visits to the bathroom to either vomit or have profuse diarrhoea- been probed, prodded or injected with goodness knows what-  I have been lying here asking myself that very question over the last few hours…

 I remember what the nurse told me in the travel clinic about water and food precautions- but how many times did I take risks??

 Was it those delicious tomatoes that I bought from a street seller but which I didn’t bother to wash… that local ice cream that was sooo refreshing… those prawns that looked so fresh… that salad… that meat that was not cooked quite so thoroughly… the buffet we treated ourselves to- how long had it been kept warm for… those ice cubes in my drink… or indeed running out of bottled water and brushing my teeth with tap water?

I have also been eating with my hands a lot and not washed them as much as I should have, and it didn’t help that I’d forgotten to pack some alcohol gel…

I wish I’d been more vigilant with precautions as I was advised,and not taken any risks…”

 

Any one of these risks could result in severe travellers diarrhoea due to transmission of a bacteria/parasites/virus/cysts.

For advice on prevention please read from the list of sources below.

 

Remember that Traveller’s Diarrhoea is the most common illness you will be exposed to and the main danger is dehydration, which, if very severe, can be fatal if untreated.

Treatment is therefore rehydration– ensuring you drink plenty of clean water, particularly salty soups and fruit juices with bland bulky foods- bread, pasta, rice and potatoes. You will also need to replace some of the lost salts by taking an oral rehydration sachet e.g. Dioralyte. Anti diarrhoea tablets should be used sparingly and only when truly necessary e.g. a long distance bus/train journey.

Contact medical help if the person has:

♦ A temperature

♦ Vomiting and unable to keep fluids down

♦ Blood or mucus in the diarrhoea

♦Persistent diarrhoea

♦ Become confused

♦Any pre existing medical conditions e.g. diabetes

 

Sources:

Students’ Health Service ‘Travel Guidelines’ patient information leaflet- available at the practice

http://www.nathnac.org/travel/misc/travellers_food.htm.

http://www.fitfortravel.nhs.uk/home.aspx.

It only takes ONE bite!

studenthealth travel, Uncategorized , , , , , , , , ,

“Off to Tanzania- leave in a couple of days! Sooo excited- mustn’t forget my yellow fever certificate- what was it the nurse said- Oh yes to photocopy it, keep this separate and put the original in my passport- good advice. I’ve been planning this trip for months- teaching English to children and construction work in a remote village. Not sure what to expect as staying with a local family- what will their home be like? What will I eat? How hard will the work be? Will they have internet close by??

Must start taking my malaria tablets… and remember to take them everyday.

 What an amazing country- full of colours, sights and smells… Love it! My host family are so welcoming and generous, I’ve settled in well- if a little homesick to start with- and enjoying the teaching. The children are sooo adorable. I have made a couple of friends here who are also doing charity work- one in particular Sarah who is staying with the same family as me.

We are sharing the same room which is rather basic but home to us now and it’s good to have the company- Luckily my little travel sewing kit came in useful as managed to tear a hole in my mosquito net on the first night!

Its such a different world here- so lovely eating dinner every evening outside under the stars- Although there are lots of mosquitoes so have been spraying myself with DEET and wearing my long shirt and trousers as the nurse in the travel clinic advised- mentioned this to Sarah, but she doesn’t seem that bothered with this- wearing vest tops and shorts- as says ‘she doesn’t usually get bitten’ and is taking her antimalarial tablets like me everyday anyway.

 We have now moved on to helping build another room for the school. Sarah hasn’t been well since waking up this morning- feeling a bit ‘fluey’ muscle aches and a headache- she reckons its too much sun as we spend a lot of our time outside now, she’s going home to bed- I’ll check on her at lunchtime…

 Sarah isn’t at all well – she now has a very high fever I’m really worried about her… I spoke to one of the charity organisers and they have sent her straight to hospital with suspected malaria. I cannot believe it! She only has a few mosquito bites- I know she didn’t cover up or use insect repellents, but she took her antimalarial tablets just as I did everyday.”

 

 

♦ Between 1990 – 2009, every year approximately 1,800 British travellers returned home with malaria.

♦ The UK is one of the biggest importers of malaria in Europe.

♦ The most severe form of malaria (plasmodium falciparum) accounted for 79% of cases amongst British travellers in 2009.

♦ Malaria is a preventable infection but can be fatal if left untreated – an average of nine people die each year from malaria in the UK.

♦ Malaria is transmitted by an infected mosquito. It only takes one bite from an infected mosquito to contract malaria.

 

Remember that antimalarial tablets reduce your risk of malaria significantly, but they are not 100% effective.

ABCD of malaria prevention:

Be Aware of the risk

Bite prevention

Compliance with Chemoprophylaxis

Recognising symptoms and prompt Diagnosis

 

Sources:

Students’ Health Service ‘Malaria Advice’ patient information leaflet- available at the practice

https://www.malariahotspots.co.uk/index.html.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A Very Peculiar Practice… or is it?

studenthealth General, Uncategorized , ,

http://www.bbc.co.uk/cult/classic/verypeculiar/videoclips/video0.shtml

I prefer to think of it as a unique and special GP Practice; after all I have worked at Students’ Health for 25 years!!

Nursing and GP colleagues in other practices have been heard to say at every possible opportunity……. “That must be a doddle, looking after students. They are all so healthy! Nice little job with long holidays!”

I say “come and work a day with us and you will be amazed at what we do!”

We experience the rich diversity of students and their lives, and love interacting with them.

 Our working days are unpredictable; from critical to chronic medical situations, chaotic to highly organised patients, all needing an individual response to meet their needs at that point in their lives!

Young people are the future and deserve the best care that we can offer them. 

Health education as in educating how to look after themselves and make good lifestyle choices not just a “sticking plaster service”.

Enabling our patients to be well informed, learn about and find the right contraceptive method.

The University of Bristol Students’ Health Service is a leading edge primary care practice with highly qualified and experienced staff.

The nurses may not deal with many pressure sores or leg ulcers but when it comes to knowing about contraception and sexual health we certainly know our condoms!

Nursing Team

Consists of 9 nurses including 2 Healthcare Assistants and all have their specialist areas such as:

Smoking cessation

Asthma / allergy

Nurse prescribers

Travel

Sexual Health and contraception

Mental health

Eating Disorders

Deliberate Self Harm

 

What can we offer you?

Great, modern facilities

Warm and reassuring welcome

A genuinely patient centred approach based on your individual needs

We really listen and won’t judge you, whatever you come with we have probably seen it before!

Practical support

Advice

Experience

 

 What can you do to help us help you?

  • Register with Students’ Health Service when you arrive in Bristol, don’t leave it until you are feeling ill or in crisis
  • Keep your appointments and arrive on time

      We have  a wide variety of appointment times available – early morning, lunchtime, evening and Saturday morning

  • Come and see us before a crisis develops
  • Understand that we will always strive for excellent clinical care, even in difficult circumstances
  • Be aware of other students’ needs, these may have to take priority if someone is seriously ill
  • Look out for each other, especially if your friends are ill
  • Our service is confidential so be honest with us

And most importantly of all have a wonderful time at Bristol University, stay safe and healthy

But if you need to……… Come and see us that is what we are here for!

 

Tickets… Passport… Sunscreen?!

studenthealth travel , , , , , ,

The holiday is in sight, the packing almost done. Some sun, sea and sand beckon… but wait a minute, that golden all-over tan…will achieving it be the most dangerous thing you do on holiday?

 Here at Students’ Health Service we have just diagnosed a malignant melanoma (skin cancer in a mole) in a student in his early twenties. It’s unusual, but not that rare. And numbers nationally are increasing, especially in men.

Two new cases of melanoma are diagnosed in the 15-34 year age group every day in the UK, that’s 900 new cases a year. A total of 12 000 in all age groups.

 Women are more at risk than men, and other risk factors include; a relative with a malignant melanoma, fair skin, red/ fair hair and pale eyes, having more than 100 moles on your whole body, severe sunburn in childhood, or an outdoor job.

 The main cause of melanoma is excessive sun exposure, and sunburn, even in theUK, can cause problems if repeated over the years.

 So if you notice a change in a mole such as darkening patches, or irregular edges, or a brand new mole growing, then we would like to see you to check it.

If you also notice bleeding/ crusting or a reddish edge then these need checking if they don’t settle back to completely normal within 2 weeks.

 So back to packing that bag; what can you do to protect yourself from sun damage and skin cancer?

 Simple measures like wearing a hat, and sunglasses with UV protection.

Always using sunscreen of SPF 15 or higher, with UVA protection too.

Keeping in the shade where possible.

Taking care not to burn and to avoid being in the sun between 11am and 3pm, with extra care nearer the equator and at high altitude.

 

These basic steps will significantly reduce your risk, not just of sunburn and melanoma but also of other non melanoma skin cancers too.

 

If you are ever worried about a mole, then please come and see any of the doctors, and you could also checkout www.sunsmart.org.uk

 

Have a great holiday!

 

Dealing with Exam stress part 2

studenthealth Exam stress , , , , , , , ,

Hi, my name’s Rick and I work at Students’ Health two days a week, delivering cognitive-behavioural based talking therapies to students struggling with difficulties such as anxiety and depression.

 As the dreaded exams loom, the people I see often find that their problems become more difficult to cope with. This is because, frankly, there are various aspects of studying at a University that are psychologically downright unhealthy:

 The perfectionism, the isolated nature of the work, the unrealistic amounts of work expected, the competitive nature of the whole thing, the lack of instant reward for the hours and hours of hard slog put in, the uncertainty about what the future holds beyond University… etc etc etc

 I still vividly remember my own struggles with all this; and anyone who was in the vicinity of the Psychology department at Exeter University in 1989 will maybe recall my own less-than-ideal attempts to cope with it.

 The good news is that 23 years later, I’m full of good ideas about how to deal with the stress of University work, most of which I’ve learned fairly recently from working here with you.

 Here are 5 top tips for psychological wellbeing at this difficult time:

 

1.   Use a diary/ schedule to plan your work and your revision

     By planning work you can break it down into manageable chunks and hopefully find it less overwhelming. Try not to plan unrealistic amounts; 5-6 hours a day is realistic for most people. Plan breaks and relaxing/ fun activities as well and try to start as early as you can: If you’ve already done 3 hours work by lunchtime, you’re less likely to get stressed as the day wears on.

     Above all, see what works for you.

 2.  Try not to compare yourself with other people

 There are always going to be people who seem to get up at 6.00am and spend their whole day in the library, working for 14 hours without a break. Do not compare yourself with these people and on no account try to compete with them. Work at a pace that suits you, and try not to pick up on other people’s stress.

 3.   Try to avoid falling into spirals of negative thinking

     There are various unhelpful styles of thinking people can fall into when under pressure. These include predicting the future, catastrophising, and  black and white thinking, among others. There’s a link to 12 of these and what to do about them attached below.

 4.   When work stress and anxiety do start to get on top of you, take a look at what you do in response to this

      Do you dive under the duvet? Go to the pub? Switch on daytime TV? Phone a friend? Go for a brisk walk around the block? Surf the internet? Go to the gym? Jump up and down and scream?

      Try writing down what you do, and try to notice what’s helpful and what isn’t, in terms of keeping you calm and allowing you to complete what you need to complete.

 5.   Remember that the whole thing is time-limited: It will not last for ever and you can only do what you can do in the time you’ve got

Soon it will all be over…

 

If you are struggling with anxiety and/ or depression and would like help and support, you can contact Rightsteps Bristol on 0117 9431111 and self refer. It is a free service. Alternately you can e-mail me at

rick.cooper@turning-point.co.uk

 http://www.getselfhelp.co.uk/unhelpful.htm

 

How to beat exam stress

studenthealth Exam stress, Uncategorized , , , , , , , , , , ,

Things the prospectus doesn’t tell you #17: Revision and exams

John Wilford, Sport Exercise & Health

 

Arrrggghhh.  Are your days broken down into 30-minute, colour-coded blocks of revision? Getting up early to claim a library desk? Staring at notes and screens until your eyes throb?  Before you know it the day ends, you’re hungry, dehydrated and your head hurts.  Welcome to the Summer term! 

 Stop. Breathe. Relax. You’re a finely-tuned, exam-passing machine. An athlete of academia. For any athlete, quality of training is more important than quantity; rest, recovery and refuelling must be programmed into their day. 

 Now look at that revision planner.  Which coloured blocks are for eating, sleeping, relaxing and exercising?  Don’t run on empty. You need to be relaxing, refuelling and refreshing yourself to survive and do well. 

 

Relaxing

  • Relaxation techniques: Practise tensing and relaxing each muscle group in turn starting with your toes and working your way up the body.
  • Breathing: Practise breathing deeply, evenly and slowly.
  • Sleep: If tired it’s hard to concentrate and maintain perspective. If you’re finding it difficult to drop off, cut down on stimulants (e.g. caffeine and alcohol) and allow time to unwind before bed. The key to feeling refreshed is having a regular pattern. Getting regular exercise helps (but not immediately before bed).
  • Massage and exercise (pilates, yoga, tai chi separately or combined in ‘Body Balance’ classes) are available from Sport, Exercise & Health
  • Therapeutic relaxation groups are organised by Student Counselling

 

Refuelling

What we eat and drink influences not only physical performance but mental performance too. If you want to boost concentration, memory and mood in the run up to exams try some of these:

  • “5 a day” of fruit and veg
  • Oily fish every week
  • Cut down “bad“ fats. Don’t rely on fast food!
  • Good breakfast to start the day
  • Eat regularly and have healthy snacks (raw carrots, celery, chopped nuts, raisins, dates, etc.)
  • Drink plenty of fluids (recent research suggests drinking water during exams can help improve grades – so don’t forget your water bottle!) though limit caffeinated and sugary drinks, especially before bed
  • Go steady with alcohol – bad for performance and sleep quality

 

Refreshing

Some anxiety can help motivate, but high levels of stress cause excess adrenaline resulting in headaches, racing heart, fatigue, irritability and sleep problems.  Physical activity uses this adrenaline, reducing these symptoms. It also releases endorphins, improving your mood.  Including some exercise in your day will boost energy and clear your head. It doesn’t have to be a two-hour gym session or a five-mile run. A brisk walk is great exercise and doesn’t need specialist kit or planning.  Even small bouts of activity can reduce tension and boost productivity.

 An organised class or activity could help.  Schedule them to fit your timetable.  It will give a welcome break from academic thoughts – and you’ll mix with different people.

 University gym staff note that many regular exercisers stop during this time of year.  Apart from one notable group – medical students.  What do they know that others don’t…..?

 

So, Wilf’s theory of revision optimisation (with apologies to mathematicians everywhere)…

 

Relaxing x Refuelling x Refreshing = Revising3

 

 

Further information:

Awkward Ailments

studenthealth Embarrassing problems , , , , , , ,

It must be twenty years since a group of us sat in a tutorial at medical school, being encouraged by our Sexual Health tutor to tell the group of all the euphemisms for ‘genitals’ that we had ever heard of.

The group moved from embarrassment (willy/ winkie), to giggle fits (woo-woo/ tuppence), to deep concentration (John Thomas?)  as we all took up the challenge. The tutorial was a success, and the colourful discussion helped us to take embarrassment out of the equation when dealing with other people’s awkward or disconcerting health complaints.

Here at Student Health we see lots of things that you might feel are embarrassing to mention, but you can be fairly sure we will have seen most of them before. And if we haven’t, well, we like a medical challenge.

The message for this blog is to reassure you that it is better to seek advice for the things that are worrying you, such as bumps on your private bits, as very occasionally they can prove to be a bit more serious, and the sooner we check them out the better. Scrotal or testicular lumps are a classic, with men of all ages being reluctant to seek a medical opinion, but it is vital that you do. If further tests are needed then a non invasive ultrasound scan will be arranged, and that really doesn’t hurt a bit, but can be life saving.

For the ladies, we are used to dealing with issues varying from the after effects of intimate waxing/ hair removal (rashes, infections, folliculitis), to ‘lost’ tampons (our nurses will retrieve them if you can’t), and itchy/ sore vulvas. One of the most effective ways to avoid the latter is to wash only with water, or possibly aqueous cream as a soap substitute, but never to use soaps/ shower gels/ bath oils/ wet wipes etc as they cause havoc with delicate skin.

Piercings are another notorious source of infections in nipples/ genitals, and need careful looking after, or removal, if not settling, as much deeper infection could follow. See us if you are concerned.

And a blog about embarrassing problems wouldn’t be complete without mentioning wee and poo, so if you noticed blood, or pain, or other significant changes when evacuating either of these, then please make an appointment with a nurse or doctor to discuss it. They usually turn out to be caused by minor ailments, but can occasionally be a sign of something more worrying.

So don’t let embarrassment damage your health! The doctors and nurses at Students Health service are here to help, and reassure you. We’ve seen it all before, and if we haven’t, then well done on making our day more interesting!

 

“Avoid using cigarettes, alcohol and drugs as alternatives to being an interesting person” Marilyn vos Savant

studenthealth Alcohol advice , , , , , , ,

Ah the mountain air, the snowy views, the sound of skis whooshing across the piste, the sight of the blood-wagon transporting another skier who has enjoyed too much vin chaud at lunchtime…

Yes it’s that time of year again, and I’m off to La Plagne for a week. And it leads me to think about all those accidents on the slopes and how much alcohol might be involved. We know that small amounts of alcohol can be good for your heart, but it’s so easy to have just a little too much, to be a little more relaxed, a little less focussed, and before you know it you’re in A&E. It’s not just skiing either. Alcohol related illness or injury leads to 1.1 million hospital admissions a year in England! The cost of this is £2.7 billion of NHS funds a year…

So, as students, does this concern you? Surely alcohol is just part of the culture, nothing to get too worked up about?

Well our latest figures here at Students’ Health suggest that around 4000 students are probably drinking at a level that is ‘higher risk’, of which up to two dozen could be diagnosed as alcoholic, though there will probably be more we haven’t met yet.

What’s higher risk you ask? For men it is more than 3-4 units a day, and for women it’s 2-3.

And what’s a ‘binge’ then? Binge drinking is defined as men drinking more than 8 units on a single occasion and women drinking more than 6 units. (A pint of lower strength beer/ lager or a standard glass of wine equals 2 units).

 So does it really matter? You’re young and healthy; won’t your body just deal with it?

Well the problems arise from both acute and long term drinking to excess. In the short term we see lower condom use, more unplanned pregnancies and more incidences of ‘regretted sex’. Binge drinking is associated with a higher rate of contracting Sexually Transmitted Infections.

Anxiety and low mood deteriorate (alcohol is a depressant, not stimulant), and accidents are more likely. Forty percent of patients admitted to A&E are seen for alcohol related injuries of illness. Alcohol is the biggest single cause of accidents in the home. One in 3 fires is caused by people under the influence of alcohol.

In the longer term we see weight gain, liver damage, depression, gastric ulcers, impotence in men, and higher risk of breast cancer in women. To name but a few…

 I suppose what I’m saying is don’t just drink… think!

Alcohol comes with a cost, not just to your bank balance, but to your health and to the NHS.

We do want you to enjoy your time at uni, but we hope you can enjoy it without any serious health consequences! If you would like to discuss any worries about your health then please do come and see one of our doctors or nurses.

 Anyway, I’m off to catch the last chair lift, then time for a healthy (!) hot chocolate!

 

www.drinkaware.co.uk

 

Misconceptions

studenthealth Contraception and Sexual Health , , , , , ,

“To be great is to be misunderstood”

 So wrote Ralph Waldo Emerson, American poet. He wasn’t talking about the Pill, (it was the 19 th century) but he should have been!

 Contraception IS great, but it is very often misunderstood…

We all have an opinion on it, but do we have all the facts?

 At Students’ Health Service we hear all sorts of myths and misconceptions ( sorry, no pun intended!) about various forms of contraception, and Valentine’s Day would seem as good a moment as any to challenge some of the  more common ones ( and one or two bizarre ones). 

 So here goes; in defence of the good old combined oral contraceptive pill; it does NOT make you “mad and fat”. Any hormonal medication could affect your emotions, but alternatives pills can be tried, and there is NO proven causal link between the pill and weight gain.

Your body does not need a ‘break’ from the pill, it is safe and convenient to take 9 weeks straight through.And as long as you always restart your pill after the 7 day break then that pill free week is equally protected.

 So now to the Emergency contraceptive pill (‘morning after pill’); it can be taken up to 72 hours after unprotected sex, and in most cases up to 5 days (an emergency coil fit is an alternative for up to 5 days too) . It does NOT affect your long term fertility at all, even if you take it twice in one cycle.

 You can get pregnant if you have sex during your period, or use the withdrawal method, and even if you have sex standing up against a wall ( I have heard all of these methods mentioned as protective against conception!).

 And finally to the most reliable method of contraception known to woman (except for your chap wearing socks,and nothing else,to bed…) The coil!

 We fit loads of these, you don’t have to have had a baby to have one, nor can they cause burst ovaries, and nor do they adversely affect long term fertility (after removal) so if you are interested, then come and see one of our coil fitting doctors.

 We give out free condoms to anyone who asks during a consultation with a doctor or nurse, and are happy to discuss all the above methods and more if you’re interested in avoiding an unplanned pregnancy during your academic studies! If you do get pregnant by accident we are here to discuss that too. Remember, all contraception is free!

 Men and women are welcome to come and discuss contraception with our clinical team, who are entirely non judgmental.

 We want to help you make the right choice for you, so come and see us soon, don’t leave it too late!

 

fpa  The Family Planning Association has more info available